Herpes zoster is a frequent complication of lymphoreticular
malignancy. In this study two assays of in vitro cellular immune response to varicella-zoster virus (VZV)
antigen, lymphocyte transformation and
interferon production, were performed in normal subjects with recent and remote VZV
infection. The responses of patients with
lymphoma were measured before treatment and during long-term remission and then compared with those of normal subjects. Despite levels of antibody to VZV that were equivalent to those in normal subjects, 44% of the untreated
lymphoma patients showed a lower transformation response to VZV
antigen than the normal patients. Production of
interferon in response to VZV
antigen was absent in 32% of the untreated patients. In contrast, lymphocyte responses in untreated patients to herpes simplex virus
antigen were within the range observed in a normal population.
Interferon production by lymphocytes in response to cytomegalovirus
antigen was also lower among untreated
lymphoma patients than among normal patients, but lymphocyte transformation was not. Twenty-two percent of
lymphoma patients in long-term remission continued to have diminished cellular immune responses to VZV
antigen. Observations in these patient populations and in normal subjects with acute
herpes zoster suggest that deficiencies in in vitro lymphocyte responses may correlate with increased susceptibility to clinical
infection with VZV.